血圧測定にかんする研究
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概要
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The investigation of the arterial blood pressure estimation: By means of the electiomanometrie CSanborn) and Korotkow's auscultatory method the arterial blood pressure was determined in the brachial artery, and following results were obtained. Systolic pressure as Fig. 3 was occasionally measured somewhat higher by Korotkow's method than by the electromanometrie; the distribution of the plotted spots tends to become divergent with the elevation of the blood pressure level. The intraarterial diastolic pressure, as Fig. 4 is more closely allied to Swan's fifth point than his fourth point. Table 1 shows the comparison between the mean blood pressure determined by Korotkow's method and that by modificated Nusser's calculation which is further examined in the next chapter. The table elecidates that the mean pressure calculated from the intraarterial pressure is found in the vivicity of pp/3 adopting Swan's fifth point as the diastolic pressure; Fig. 5 demonstrates these results in schema. Both one half of pulse pressure which is measured from the diastolic pressure adopting the fifth point and one half or one third of the pulse pressure which is estimated from the diastolic prssure using the fourth point, are always found somewhat higher. The relationship between Manschett - and intraarterial pressure is never simple; the former depends largely upon the state of the soft tissue including the circumference of arm, while the latter consisderably upon "Staudruck" in Sahli's sense. Criterion upon Nusser's formula : As Fig. 6, by means of formula (1) and (2) (P. 359) the mean Pressre can be calculated from the intraarterial pressure. At this event, Φ is an index denoting at what part of the pulse pressure does the mean pressure occupy. Nusser et al. classified the intraarterial pressure wave into the plus wave, the minus wave, and the stationary wave; especially in order to estimate the two formers the formula (3) and (4) (P. 359) were presented, and each of respective Φ was named as Φ_+, Φ_- and Φ_s. However auther calculated with accordance in formula in Fig. 7 (P. 359); as Fig 7 (P. 359), for the purpose of the derermination of the diastolic pressure the proximal and the terminal portion of the pressure wave are adopted and each of the respective pulse pressure is named vPp and nPp from which Φ is calculatedand each of the respective Φ is named Φv, Φn. Fig. 8 (T. 359) set the value estimatedby Nusser against that byus. Indifferently from Φ_+, Φ_-, Nusser's value is found always between Φv and Φn. Fig. 11 (P. 360) shows Φv, Φn determined byour method in the brachial artery, namely M±σ=0.43±0.10, 0.42±0.09 respectively. Fig. 12 (P. 360) demonstrated Φv, Φn observed in the femoral artery, in this case there exists on significant difference between the mean values of Φv & Φn. Fig. 13 (V. 361) shows Φv, Φn obtained in the brachial artery of the normotensive group and Fig. 14 (P. 361) of the hypertensive; the latter impresses that Φ in the hypertension is relatively uniform. Fig. 15 (P. 361) demonstrates Φ found in the heart diseases, Fig. 16 (P. 361) in the various kinds of arrhythmia. Fig. 9 (P. 360) observed in the auricular fibrillation affords a striking illustration of the fact that the calculation of Φ is very difficult by means Nusser's of method. In contrast to Nusser's method, our calculation permits easily to understand the nature of the pressure wave, although there may exsit apparently some complexity because of two Φ in one pressure wave, however indepently from the rhythmia or the arrhythmia, our calculation can be performed quite simply. For the purpose of the determination of the diastolic pressure, there may occur a question whether the initial portion of the pressure wave, or the lowest point may be adopted; author has used the latter, because at the present time there is no practical way to measure the intravascular "Staudruck" satisfactorily.
- 千葉大学の論文
- 1958-07-28